ABSTRACT
In today’s world, health views have found a wider perspective in which non-medical expectations are particularly
catered to. The health system reform plan seeks to improve society’s health, decrease treatment costs, and increase
patient satisfaction. This study investigated factors affecting the successful establishment of a health system reform
plan. A mixed qualitative – quantitative approach was applied to conduct to explore influential factors associated
with the establishment of a health system reform plan in Iran’s public hospitals. The health systems and approaches
to improving them in other countries have been studied. A Likert-based five-point questionnaire was the
measurement instrument, and its content validity based on content validity ratio (CVR) was 0.87. The construct
validity, calculated using the factorial analysis and Kaiser Mayer Olkin (KMO) techniques, was 0.964, which is a
high level and suggests a correlation between the scale items. To complete the questionnaire, 185 experts,
specialists, and executives of Iran’s health reform plan were selected using the Purposive Stratified Non Random
Sampling and snowball methods. The data was then analyzed using exploratory factorial analysis and SPSS and
LISREL software applications. The results of this research imply the existence of a pattern with a significant and
direct relationship between the identified independent variables and the dependent variable of the establishment of a
health system reform plan. The most important indices of establishing a health system reform plan, in the order of
priority, were political support; suitable proportion and coverage of services presented in the society; management
of resources; existence of necessary infrastructures; commitment of senior managers; constant planning,
monitoring, and evaluation; and presentation of feedback to the plan’s executives, intrasector/extrasector
cooperation, and the plan’s guiding committee. Considering the indices, it can be argued that the presented models
enjoyed good model fit and the desired correspondence existed between the depicted or constructed model and the
experimental data. In other words, the above-named variables possess the necessary qualifications to be used in the
form of a final research model.
Keywords: Health System, Health Reform, Hospitals